Sunday, October 11, 2009

Disc Problems in Neck and Upper Cervical Care

Kirk Eriksen, D.C.

Objective: To discuss the chiropractic management of a patient suffering from multiple complaints, including a herniated nucleus pulposus in the cervical spine diagnosed by magnetic resonance imaging (MRI).

Clinical Features: A 34 yr old man suffered from severe neck, lower back and radicular pain of 1 yr duration. He had previously received care from multiple medical specialists with little or no results. An MRI of the cervical spine demonstrated a C6-C7 herniated nucleus pulposus. A needle electromyogram examination confirmed the presence of a C6-C7 radiculopathy with radiculopathetic changes from C4-C7. X-ray analysis showed that the atlas and axis were misaligned. These X-rays were read manually (with a template) and with computer-assisted digitization. Computerized analysis also measured misalignments at the levels of L4-L5.

Intervention and Outcome: The patient was managed primarily with the Grostic Procedure of upper cervical adjusting by hand. After a period of about 1 month, a series of re-examinations revealed a dramatic improvement in all subjective and objective findings. A follow-up of greater than 1 yr has shown that surgery was not necessary.

Conclusion: This single case study suggests that chiropractic care may be a viable treatment option for patients with cervical disc herniation. Further investigation into chiropractic adjustments and this condition should be pursued (J Manipulative Physiol Ther 1998: 21:51-6).

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